National Ecclesiastical Refund & Payment Request
Please complete our payment & refund form below. All payment & refunds, if applicable will be given within the term of the contract and are paid in the order of approval. Any question, please email all questions/concerns to arap@dmecs.org
Name
*
First Name
Last Name
Email
*
Confirmation Email
example@example.com
Request Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Refund
*
Services doesn't work
Wrong Services Delivery
Excessive Amount
Overpayment Review
Invoice Due
Staff/Member Invoice
Student Account-Payout
Services Name
What was the services requested.
Product ID
*
When did you obtain the our services?
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Contract or Invoice.
*
Browse Files
Cancel
of
Your Contract or Invoice.
Browse Files
Cancel
of
Your Contract or Invoice.
Browse Files
Cancel
of
Please read the following questions.
*
Rows
Yes
No
Do you have the invoice?
Have you read the refund policy?
Based on the refund or payment policy, are you eligible for a refund/payment?
Did you have a contract?
Requested Amount
Additional Notes
Signature; By signing this form you agree to all terms and conditions.
*
Submit
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